Pelvic organ prolapse (POP) is a medical condition that occurs when the normal support of the vagina is lost, resulting in “sagging” or dropping of the bladder, rectum, urethra and cervix. As the prolapse of the vagina and uterus progresses, women can feel bulging tissue protruding through the opening of the vagina.
Uterine prolapse is the second most common after bladder and urethral prolapse. The uterus is held in position in the pelvis by muscles, special ligaments, and other tissue; when these muscles and connective tissues weaken, the uterus drops (prolapses) into the vagina.
Uterine prolapse is fairly common in women who have had one or more vaginal births, especially when delivering babies over nine pounds. The risk of developing this condition increases with age.
During a woman’s childbearing years normal levels of estrogen help to keep the pelvic muscles strong. Normal aging and decreased production of the female hormone estrogen after menopause may cause uterine prolapse. After menopause, hormone replacement therapy can help to maintain muscle tone. Chronic cough, constipation and obesity can worsen the condition by increasing the pressure on the pelvic floor. Uterine prolapse can also be caused by a pelvic tumor, although this is rare.
Some symptoms of uterine prolapse include:
• A feeling as if sitting on a small ball
• Protruding of the uterus and cervix through the vaginal opening
• Difficult or painful sexual intercourse
• Frequent urination or a sudden, urgent need to empty the bladder
• Vaginal bleeding or increased vaginal discharge
• Low backache
• Repeated bladder infections
• Sensation of heaviness or pulling in the pelvis
Many of these symptoms are worse when standing or sitting for long periods of time. Treatment is not necessary in mild cases unless the symptoms are bothersome, however, most women seek treatment by the time the uterus drops to the opening of the vagina. In severe cases, untreated uterine prolapse can interfere with bowel, bladder and sexual functions. Uterine prolapse can be treated with a vaginal pessary or surgery.